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Biomedical subjects

P Beutter

Publications and source records attributed to P Beutter.

At least 73 records · Page 4Linked to original sources
PubMed1981

[Carcinoma of the upper respiratory and digestive tracts. Histopathology and chemotherapy in 300 cases (author's transl)].

The pathological review of 300 larynx hypopharynx and pyriform sinus carcinoma was done systematically. The results expressed according to the absence or the type of chemotherapy (Bleomycine alone or O.M.B. association) are analysed. There is no difference for the epithelial proliferation but the collagenous part of stroma was enhanced by therapeutic. The foreign body granulomas are related to the tumor maturation (keratinization).

Antineoplastic Agents↗
PubMed1981

[The role of primary surgery in the treatment of carcinomas of the tonsillar region (author's transl)].

The aim of this study was to identify the role of surgery in the treatment of carcinomas of the tonsillar bed. A retrospective review involved 158 records of patients treated between 1969 and 1979. It emerged that locoregional failures were more frequent after primary radiotherapy than after primary surgery. Only a limited number of patients could be treated and cured by secondary salvage surgery. The high prevalence of locoregional failures after radiotherapy and new techniques for reconstruction after extended resection have led us progressively to adopt an attitude based upon primary surgery in the treatment of carcinomas of the tonsillar bed.

Carcinoma↗
PubMed1981

[Tracheotomy in the surgical treatment of carcinomas of the pharyngo-larynx (author's transl)].

The authors studied the local postoperative course and period of hospitalisation after 890 total and partial pharyngo-laryngectomies according to whether the operation was started under general anaesthesia by intubation or after tracheotomy under local anaesthesia. The authors show the improvement in postoperative course as well as the decrease in the period of hospitalisation when intubation was used first.

Anesthesia↗
PubMed1981

[Laryngeal and laryngotracheal stenoses. Classification and treatment (author's transl)].

Results of treatment of 63 cases of laryngeal and laryngotracheal stenosis are presented and a classification of these lesions discussed. Two main types are distinguished: simple isolated stenoses (arytenoid, cricoid and tracheal) and compound stenoses (arytenocricoid, tracheocricoid, arytenotracheocricoid, arytenotracheal). Only arytenoid stenoses, those with an arytenoid component, or lesions associated with laryngeal paralysis provoke cord immobility. The arytenoid lesion therefore differentiates stenoses with fixed from those with mobile vocal cords. Treatment mainly involves adequate enlargement of the larynx and crico-tracheal resection, or a combination of these two techniques. Results were positive in 45 cases, insufficient in 5, and nil in 2 cases. Four patients were not seen again, one patient died, and 3 are still being treated. Three patients with successful results still retain a temporary tube while awaiting further therapy for another affection (esophageal stenosis). Results are analysed as a function of the site of the stenosis, the presence or absence of a tracheotomy, the technique employed, and whether previous treatment had been employed. Excluded from this report, which concerns 63 patients with laryngeal or laryngotracheal stenoses treated in the Hôpital Laennec, Paris, were cases of pure tracheal stenosis treated by resection and tracheotracheal or cricotracheal anastomosis, and with healthy cricoids, and synechiae or anterior glottic (or anterior commissural) stenoses. They were either congenital, or iatrogenic following endoscopic surgical procedures in the glottic region. Also excluded were cases of stenosis where surgery was not indicated, as well as two patients with laryngeal stenosis, one due to an amyloid tumor and the other to Launois Bensaudes disease.

Adult↗
PubMed1981

[Partial vertical surgery of the larynx : results as a function of anesthesia and the employ of tracheotomy (author's transl)].

Postoperative course and complications were studied as a function of the type of anesthesia, and the employ of a tracheotomy tube and gauze drainage of the laryngeal cavity, following partial vertical surgery on the larynx of 238 patients. Findings demonstrated that a general anesthetic by intubation with total skin closure without tracheotomy and gauze drainage of the laryngeal cavity, reduced the incidence of local infections complications and the duration of hospitalization. Without insisting on the advantages of this type of anesthesia and the value of immediate suturing, the authors note that these simple techniques markedly reduce the hospitalization period at a time when emphasis is being placed on the economic impact of the duration of this period.

Anesthesia↗
PubMed1980

[Epitheliomas of the margin of the larynx. Definition, classification and extension (author's transl)].

Studying 213 cases of epithelioma of the laryngeal margin, the authors report on a 3-part study. The first part defines, classifies and specifies the extension of marginal epitheliomas, the second part studies anterior margin epitheliomas and the third, epitheliomas of the lateral margin. This first part shows that the laryngeal margin forms a precise anatomo-clinical entity which must be subdivided into anterior lateral posterior and total margins. The anterior margin consists of the free edge, the supra-hyoid laryngeal side of the epiglottis and, for the authors, the laryngeal side of the epiglottis that belongs, for the UICC, to the oropharynx. The lateral margin consists of the aryteno-epiglottic fold and, for the authors, of the intersection of the three fold that are not mentioned in the UICC or the AJC classifications. The arytenoid cartilage forms the posterior margin. Together, tumors of the anterior margin and the lateral margin make up for 94% of marginal tumors. This first part specifies the macroscopic aspects of marginal epitheliomas with their local and lymphatic extension.

Carcinoma↗
PubMed1980

[Epitheliomas of the anterior margin of the larynx. A study of 102 cases (author's transl)].

In this second part, we study 102 cases of epithelioma of the anterior margin of the larynx. The authors insist on the need for bilateral treatment of lymphatic areas on account of their frequent bilateral involvement, jumping from 9% for N0 to 80% for a fixed unilateral enlarged lymph node. Whatever the T stage, the best therapeutic results are provided by total or partial surgery of the lesion combined with surgical treatment of lymphatic areas completed by irradiation.

Carcinoma↗
PubMed1980

[Epitheliomas of the lateral margin (author's transl)].

The third part ends the study on epitheliomas of the laryngeal margin and concerns 8 cases of epithelioma of the lateral margin (aryteno-epiglottic fold and intersection of the three folds). The authors emphasize the considerable lymphatic tropism of these tumors. In 58% of these, enlarged lymph nodes were found, 65% of which showed histological involvement. Best results (survival and local sterilisation) are provided by surgery, partial or complete, depending on the T stage, the tumoral site, and combined with lymphadenectomy, completed by irradiation.

Carcinoma↗
PubMed1980

[Laryngotracheal stenosis. Indications and results on the basis of 59 cases (author's transl)].

On the basis of 59 cases of laryngotracheal stenosis, the authors summarised their experience in 3 chapters. The first section defines the etiology, therapeutic indications and results obtained according to whether the stenosis was purely laryngeal or laryngotracheal and whether the vocal cords are mobile or immobile. The second part studies the results of procedures of enlargement of the laryngeal cavity (Rethi-Aboulker type). These results are satisfactory in pure laryngeal stenosis, but are often inadequate for stenosis of the crico-tracheal junction or combined laryngeal and tracheal stenosis. The third part defines the technique and indicates the value of crico or thyrocrico-tracheal resection anastomosis procedures in laryngotracheal stenosis. Thus, there is not single form of treatment for laryngotracheal stenosis. On the basis of pre and per-operative assessment, a choice will be made between the Rethi procedure, crico-tracheal resection or combination of the two.

Adult↗
PubMed1979

[Lymphadenopathies associated with carcinoma of the larynx (author's transl)].

On the basis of 287 cases of carcinoma of laryngeal origin, treated by total or horizontal sub-glottal laryngectomy, the authors study the prognosis in lymphadenopathies. This prognosis is envisaged in the light of the international nomenclature NO, N1, N2, N3, in relation to the size of the nodes and, finally, in relation to the surgical or radiotherapeutic treatment given to the node areas. The authors emphasise the need for bilateral surgery to the node areas, this procedure being all the more extensive when the lymphadenopathy is larger. On the basis of this size, a choice must be made between radical dissection, extended cellulo-adenectomy (or functional excision).

Humans↗
PubMed1978

[Partial surgery of carcinomas of the glottis. Results and prognosis (author's transl)].

The authors present a computerized study of the prognosis of 132 cases of carcinoma of the glottis treated by vertical, partial surgery and seen over a period of 1 to 15 years at the Laennec Hospital. After defining the percentage survival at 3.5 in 10 years, the authors studied the causes of death and showed that, after 5 years, it is still deaths due to malignant recurrence which influenced the vital prognosis. These local, lymphnode and metastatic oncological failures are subsequently analyzed on the basis of clinical, surgical and histological parameters as well as in terms of the course of the disease. Such analysis makes it possible to draw the distinction between local recurrence and a second local tumor localization, and pulmonary metastases from a second pulmonary localization. Finally, the prevention of rare lymphnode recurrences is considered in terms of specific surgery for this purpose.

Chronic Disease↗
PubMed1976

[Our experience with pulsed oxygen and general anesthesia in direct suspension laryngoscopy].

The authors describe a group of 77 direct suspension laryngoscopies in which general anaesthesia and oxygen therapy were used. The technique is described in considerable detail. The catheter used is independent of the laryngoscope and is passed into the nasal cavity. Analysis of the gases in the blood of 15 patients showed that after three minutes of apnea, ventilation was still satsifactory. No pneumothorax occured during this type of anaesthesia. For the O.-R.-L. practitioner using the method, the advantages are as follows: induction anaesthesia is quicker than after neuroleptanalgesia, exposure of the larynx is excellent due to curarization and three endoscopies can be carried out in the same operation: laryngoscopy, oesophagoscopy and bronchoscopy. The disadvantage of general anaesthesia is that it makes it impossible to judge the mobility of the larynx. In 7,8 p. 100 of the cases, direct suspension laryngoscopy proved difficult or impossible to carry out fir anatomical reasons.

Alfaxalone Alfadolone Mixture↗
PubMed1976

[An unusual and dangerous clinical form: chronic osteomatous otitis].

Some chronic otites result in local or diffuse attico-antral osseous outgrowths. These may complicate all sorts of chronic otites: cholesteatomatous or otherwise, suppurative or merely inflammatory, with the tympanum open or closed. They should be distinguisged from tympanosclerosis and condensation or osseous eburnation lesions. They seem to result from post-inflammatory irritation causing metaplastic bone growth or from an exostosis. The key to their diagnosis lies in radio-tomography. From the surgical point of view, diffuse attico-antral forms are particularly dangerous and deadly. It is essential that the kopho-surgeon should be aware of their existence which, as far as we know, does not seem to have been noted so far.

Adult↗
PubMedDate not supplied

Carcinoma of the laryngeal margin.

The laryngeal margin constitutes an anatomic and clinical entity that differs from what is commonly referred to as supraglottic. The present retrospective study reviews 189 cases of carcinomas occurring in this specifically defined region. Local, nodal, and distant metastatic spread of these tumors varied depending on whether the initial tumor site was located in the anterior or lateral margin. Treatment regimens were planned according to the tumor's origin. Primary tumor site surgery associated with a modified or radical neck dissection according to N staging, followed by postoperative radiation is advocated for treatment of these tumors. Cervical nodal metastases are frequent and often bilateral (36%) in cases of anterior margin carcinoma suggesting that bilateral neck dissection sparing two jugular veins for N0 staged carcinoma and one jugular vein when there is evidence of a palpable node, be routinely used. Nodal involvement in cases of lateral margin carcinoma is also frequent but is almost exclusively confined to the ipsilateral nodes. It is suggested that homolateral neck dissection therefore be systematically associated with primary tumor site surgery for these tumors. The various anatomical aspects and pathways of extension of laryngeal margin carcinoma are discussed and a modified TNM classification is proposed.

Carcinoma↗
PubMedDate not supplied

[Prognostic value of the number of involved nodes after neck dissection in oropharyngeal and oral cavity carcinoma].

PURPOSE: To evaluate the relationship between the number of positive nodes and probabilities of locoregional control and survival in patients with invasive squamous cell carcinomas of the oral cavity and oropharynx. MATERIAL AND METHODS: Between 1976 and 1993, we treated with curative intent 183 patients (median age: 56 years; standard deviation: 10 years). Seventy-nine patients (43%) had oropharyngeal primary invasive carcinoma and 104 (57%) had oral cavity (excluding the lip) primary invasive carcinoma. Patients with simultaneous primary lesion or visceral metastases were excluded from the analysis. All the patients had neck dissection with at least six nodes to analyse. One-hundred fifty-nine patients (87%) underwent resection of the primary lesion and 158 (86%) were treated postoperatively with external beam irradiation alone or combined with interstitial implant (median dose: 60 Gy; standard deviation: 10 Gy). Average follow-up was 52 months. RESULTS: The overall 5-year survival rate using the Kaplan-Meier method was 42.6%. The 5-year survival rates were 60.0% when lymph nodes were histologically negative, 39.5% when one lymph node was positive, 28.0% when two lymph nodes were positive and 24.4% when three or more lymph nodes were positive (P = 0.0004). The number of positive nodes did not significantly influence the specific disease-free survival and locoregional control rates. CONCLUSION: Patients with one or more positive neck nodes must have postoperative treatment.

Adult↗
PubMedDate not supplied

Brainstem auditory evoked responses in patients with tinnitus.

Brainstem auditory evoked responses of 355 patients with uni- or bilateral tinnitus were recorded in order to evaluate the effect of tinnitus on the central auditory system. The amplitudes of waves I, III and V and the latencies of each wave and interpeak latencies were compared to those of a group of 129 controls with normal hearing. The study of the control group initially identified a certain number of concurrent parameters. The brainstem evoked responses of men and women evolved differently from the age of 30 years, latencies of I-III and I-V in men lengthening with age and those of women tending to shorten. The patient groups were therefore compared to a control group of the same sex ratio or of the same sex, half being between 30 and 56 years of age. The tinnitus patients were divided into three groups according to the side affected by tinnitus. Latencies and amplitudes in these groups differed significantly from those of the control group. In order to eliminate hearing loss, the most difficult concurrent factor and almost always associated with tinnitus, the results of individuals with symmetrical hearing loss were compared to those of the control group. Tinnitus was always associated with significant lengthening of 0-I and I-V latencies on the tinnitus-affected side, with a significant reduction in amplitudes of waves I and III, and sometimes of wave V, particularly in the group with left-sided tinnitus. Comparison of tinnitus patients with symmetrical and asymmetrical hearing by sex showed that tinnitus patients of all groups had lengthening of right and left 0-I latencies, apart from the women in the group with right-sided tinnitus, and significant reduction in amplitudes of waves I and III in women and of left III only in men. When hearing loss was asymmetrical and on the tinnitus-affected side, there was also lengthening of 0-I latencies on the tinnitus-affected side in both sexes and of ipsi- and contralateral I-V latencies in women. Right- and left-sided tinnitus was associated with additional differences between the three groups. Correlation coefficient study confirmed that 0-I, I- III and I-V latencies were independent of the mean degree of deafness, deafness at high frequencies and at frequencies around the tinnitus, up to a threshold of hearing loss of 40 dB, above which 0-I and 0-V lengthened in addition to tinnitus. On the other hand, whatever the frequency, tinnitus involved significant lengthening of wave I latencies and modification of the previously recorded amplitudes. Two groups of tinnitus patients could be distinguished: the first, with symmetrical hearing loss, with symmetrical normal latencies, apart from 0-I latencies and the amplitude of the wave on the tinnitus side, and the second with hearing loss predominant on the tinnitus-affected side, with different latencies on each side, 0-I being shorter on the unaffected side, I-III and I-V being lengthened on the unaffected side and 0-I being lengthened on the tinnitus-affected side. Moreover, as disturbances of brainstem evoked responses caused by tinnitus particularly affected waves I and III, the hypothesis of possible involvement of the efferent systems could be proposed.

Adolescent↗